Guided dental implantation system and associated device and method

ABSTRACT

A dental implantation system is provided, comprising an implantation device adapted to prepare a site within a mouth of a patient for receiving a dental implant. A guidance device is operably engaged with the implantation device and is adapted to operably engage the mouth of the patient. The engagement between the guidance device and the mouth of the patient provides a fiducial marker for guiding the implantation device to prepare the site for receiving the dental implant. An associated method of implanting a dental implant, and associated devices, are also provided.

CROSS-REFERENCE TO RELATED APPLICATION

This application claims the benefit of the filing date of U.S.Provisional Patent Application Ser. No. 61/041,722, filed Apr. 2, 2008,which is incorporated by reference herein in its entirety.

BACKGROUND OF THE INVENTION

1. Field of the Invention

Embodiments of the present invention are directed toward robotic systemsfor dental surgery and, more particularly, to a guided dentalimplantation system and associated device and method.

2. Description of Related Art

Patients who are missing teeth, whether it be one, several, or an entirearch, may be candidates for dental implants. Patients who want a morepermanent solution than dentures, bridges, or other tooth replacementmeasures may also be interested in dental implants.

The dental implantation procedure generally involves an invasiveincision into the gum of the patient in order to allow the practitionerto view the underlying jawbone structure. A hole is then drilled intothe jawbone structure, into which a dental implant is placed (see, e.g.,FIG. 1A). In some instances, the dental implant may be shaped, forexample, like a screw. Once the dental implant is inserted into thejawbone structure, an external post is attached to the dental implant(see, e.g., FIG. 1B), and a prosthetic cap (tooth reproduction) attachedto the post (see, e.g., FIG. 1C).

With computerized tomography (CT) and other imaging scans becoming morecommon, the practitioner may be able to graphically visualize thejawbone structure, without or before the invasive incision. However, thealignment of the dental implant with respect to the jawbone structureand/or relative to other implants or teeth may be an important factor indetermining, for example, the life of the dental implant, the appearancethereof, and the comfort to the patient. If the dental implant is poorlyor otherwise not optimally placed, the dental implant can undesirablyfail (or at least have a shorter service life), may undesirably causeother teeth or dental implants to be compromised, and/or damage proximalnerves.

Thus, there exists a need for a system and method for providing animproved dental implantation procedure that addresses the notedshortcomings of current procedures, and facilitates, for example,effective pre-surgical planning and guidance during the surgicalprocedure.

BRIEF SUMMARY OF THE INVENTION

The above and other needs are met by the present invention which, in oneaspect, provides a dental implantation system, comprising animplantation device adapted to prepare a site within a mouth of apatient for receiving a dental implant. A guidance device is operablyengaged with the implantation device and is adapted to operably engagethe mouth of the patient. The engagement between the guidance device andthe mouth of the patient provides a fiducial marker for guiding theimplantation device to prepare the site for receiving the dentalimplant.

Another aspect of the present invention provides a method of implantinga dental implant, comprising determining a fiducial marker from anengagement between a guidance device and a mouth of a patient; andguiding an implantation device operably engaged with the guidancedevice, with respect to the fiducial marker, so as to prepare a sitewithin the mouth of the patient for receiving the dental implant.

Various other aspects of the present invention are directed to componentdevices and associated methods facilitating the dental implantationsystem and method of implanting a dental implant, as otherwise disclosedherein.

Aspects of the present invention thus provide distinct advantages asotherwise detailed herein.

BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWING(S)

Having thus described the invention in general terms, reference will nowbe made to the accompanying drawings, which are not necessarily drawn toscale, and wherein:

FIGS. 1A-1C schematically illustrate a dental implantation procedurewith respect to the mouth of a patient;

FIG. 2 schematically illustrates a dental implantation system accordingto one embodiment of the present invention;

FIGS. 3 and 4 schematically illustrate a dental implantation systemaccording to an alternate embodiment of the present invention; and

FIG. 5 schematically illustrates preparation of a prosthetic member witha dental implantation system according to one embodiment of the presentinvention.

DETAILED DESCRIPTION OF THE INVENTION

The present invention now will be described more fully hereinafter withreference to the accompanying drawings, in which some, but not allembodiments of the inventions are shown. Indeed, these inventions may beembodied in many different forms and should not be construed as limitedto the embodiments set forth herein; rather, these embodiments areprovided so that this disclosure will satisfy applicable legalrequirements. Like numbers refer to like elements throughout.

FIG. 2 and FIGS. 3 and 4 illustrate alternate embodiments of a dentalimplantation system according to the present invention, the system beinggenerally indicated by the numeral 100. As previously indicated, currentdental implantation procedures generally involve an imaging step,wherein CT or other appropriate images of the patient's jaw structureare obtained, and any anomalies diagnosed (i.e., whether the patientrequires bone grafts to prepare the implant area). The practitioner thencorrects any anomalies and proceeds with the invasive implant procedurebased on the conditions associated with the patient's jaw structure,once the appropriate incisions have been made in the patient's gum.

A dental implantation system 100 according to various aspects of thepresent invention addresses the subjective aspects of current dentalimplantation procedures by providing a guided implantation device 150(otherwise referred to herein as a “cutting device”) configured to beguided with respect to the invasive portion of the dental implantprocedure (i.e., to “prepare” the site within the patient's mouth). Thatis, the implantation device 150 is operably engaged with a guidancedevice 200. The guidance device 200 is adapted to operably engage themouth of the patient. For example, the engagement with the mouth of thepatient may be through a splint 250 or other engaging member. In oneinstance, the splint 250 is configured to engage the patient's mouth ina “firm” or secure interaction (i.e., the splint 250 is engaged with thepatient's teeth and does not move with respect to the patient's mouth).Since the splint 250 does not move with respect to the patient's mouth,the disposition of the splint 250 is known, and thus can be configuredto provide a fiducial marker (i.e., a known origin or coordinate) whichcan be used, for instance, to guide the implantation device to preparethe site in the patient's mouth for receiving the dental implant 300(see, e.g., FIG. 1B). In one aspect, the splint 250 is configured to be“universally applicable” (i.e., capable of forming the secure engagementwith the mouth of any patient), or at least applicable across aparticular range of patients (i.e., one size fits a certain size or ageof patient). In order to determine the fiducial marker, according to oneaspect of the invention, the splint 250 may be engaged with thepatient's teeth and the patient's jawbone structure then imaged using,for example, CT or any other suitable imaging technique such as, forinstance, MRI.

With respect to the imaging procedure, one skilled in the art willappreciate that the implantation procedure generally involves only onejawbone structure. That is, the implant is generally intended to beplaced in either the upper jawbone structure or the lower jawbonestructure of the patient. As such, it may be important to obtain asclear and detailed an image of the subject jawbone structure aspossible, which may be hindered by interference of the teeth of theopposing jawbone structure. Accordingly, it may be desirable to define aseparation or other distinction between the upper and lower jawbonestructures during the imaging procedure. Accordingly, the imagingprocedure according to one embodiment of the present invention mayfurther comprise a separator device (not shown) inserted between thepatient's jawbone structures as the images are acquired. For example,such a separator device may comprise a block, plate, or otherappropriate physical structure inserted into the patient's mouth, inconjunction with, or separate and discrete with respect to, the splint250. The separator device may also include a separation indicator (notshown) element comprising a radiopaque material (i.e., a metallicmaterial) that can be clearly defined in the image, wherein theseparation indicator is disposed within or otherwise associated with theseparator device so as to define a jawbone structure separation line,plane, or other suitable boundary. Accordingly, the separator deviceallows each jawbone structure to be imaged separately of the other(i.e., without interference) and, once the image is acquired, imageprocessing techniques may be applied to the image in order to separatethe image along the jawbone structure separation line, plane, or otherboundary defined by the separation indicator so as to segregate (fromthe imaging standpoint) the jawbone structure receiving the implant. Oneskilled in the art will also appreciate that, since the configuration ofthe separation indicator is known, deviation from the configuration inthe captured image may indicate, for example, undesirable movement ofthe patient during the imaging procedure. For example, a curvedseparation line shown in the image, when the separation indicator isactually a straight rod, may indicate that the patient moved during theimaging procedure, and that the procedure must be repeated to obtain asuitable image.

One skilled in the art will also appreciate that the splint 250 may beconfigured in many different manners to accomplish the desired functionas discussed herein. For example, the splint 250 may be rigidly attachedto the patient's mouth in an appropriate manner depending on thecondition of the patient. That is, if the patient has some strong teethcapable of supporting the splint 250, the splint 250 can be attached tothe teeth with an adhesive or with a suitable clamp. For edentulouspatients (i.e., without teeth), bone pins may be drilled through thesplint 250 and into the patient's jawbone structure to fasten the splint250 securely into place. The splint 250 may also be attached to thejawbone structure of any patient using, for example, appropriate bonescrews. In one aspect, the positioning of the splint 250 with respect tothe patient's mouth may not be critical or important, as long as thesplint 250 remains rigidly in place. A fiducial marker (not shown) maythen be attached to, or otherwise incorporated into, the splint 250,wherein the fiducial marker may be configured to have a geometry orother characteristic or feature that uniquely defines the fiducialmarker in a three-dimensional space (i.e., such that the fiducial markeris readily identified in images of the patient's jawbone structure). Insuch instances, the fiducial marker may be comprised of, for example, aradiopaque material that can be clearly defined in the image (e.g., CTor MRI).

In one instance, the implantation device 150 is engaged with anarticulating arm member 350 (i.e., a robotic arm) which determines arange of motion of the implantation device 150. The guidance device 200,in such instances, may further comprise a communication element 400 incommunication between the splint 250 and the implantation device 150and/or the arm member 350. For example, the communication element 400may comprise a mechanical linkage connecting the splint 250 to theimplantation device 150/arm member 350. That is, the communicationelement 400 may comprise, for example, a mechanically-tracked arm whichattaches to the splint 250 engaged with the patient. In some instances,the arm may be attached to the splint 250 (rigidly and in a known,repeatable manner) with an attachment mechanism comprising a kinematicmount. Attached to the patient in this manner via the attachmentmechanism and the splint 250, the communication element 400 providesdata (whether constantly, selectively, or otherwise as necessary) aboutthe position of the patient (i.e., with respect to the fiduciary) to theimplantation device 150/arm member 350, while still providing foraccurate guidance thereof in the event that the patient moves. However,one skilled in the art will appreciate that the splint 250 and/or thefiducial marker determined thereby may be communicated to theimplantation device 150/arm member 350 in many different manners. Forexample, the fiducial marker may be communicated via a communicationelement 400 comprising a wireless transceiver, a hardwire connection, anoptical communication system, or any other suitable mechanism, whetherelectrical, mechanical, electromechanical, or optical in nature. In anyinstance, the guidance device 200 may be further configured to include acontroller device 450 (i.e., a computer device as shown in FIGS. 3 and4) for determining the fiducial marker from the image of the patient'smouth having the splint 250 disposed therein, and for appropriatelycommunicating the fiducial marker to the implantation device 150/armmember 350.

In one aspect, the controller device 450 may be further configured toreceive the image of the patient's jawbone structure (having the splint250 therein). In some instances, the controller device 450 may befurther configured to be capable of executing an implantation routinethat may comprise software, hardware, or a combination thereof. Theimplantation routine thus allows the practitioner to create, forexample, a virtual implantation plan based on the captured image,whether in two dimensions or three dimensions, and to manipulate theimage(s) of the patient's jawbone structure in conjunction with a“virtual implant” in order to develop the virtual implantation plan orplacement determination for the patient in conjunction with acomputerized model based on the image(s). In some aspects, theimplantation routine, virtual implantation plan, and/or placementdetermination may be created in relation, for example, to a coordinatesystem (relative or absolute), as will be appreciated by one skilled inthe art, for associating the implantation parameters with the fiducialmarker. In other aspects, the controller device 450 may include aperipheral device (i.e., a trackball or joystick in conjunction with,for example, 3 D goggles, all not shown) to assist with or otherwisepermit virtual manipulation the placement of the virtual implant(s) withrespect to the image(s) in order to, for example, align the implant(s)relative to each other or relative to adjacent teeth, to align theimplant(s) relative to the affected nerve, and to align the implant(s)relative to the jawbone structure. The controller device 450 may befurther configured to perform such manipulation manually, automatically,or semi-automatically, as necessary or desired. Because the virtualimplant(s) may be manipulated in a similar manner to the image(s), theorientation or placement of the virtual implant(s) may represent thedesired actual placement of the implant with respect to the patient'sjawbone structure, thus providing an intuitive interface for planningthe implantation procedure.

In aspects where the splint 250/fiducial marker approach is used, thepatient is automatically registered with the system 100 once thecommunication element 400 (arm) is attached to the splint 250 via thekinematic mount of the attachment mechanism. That is, the fiducialmarker is automatically determined from the image(s) of the patient'sjawbone structure, and the alignment and location thereof in physicalspace is known due to the kinematic mount connecting the arm to thesplint 250. One skilled in the art will appreciate, however, that otheralignment approaches may be implemented that do not necessarily requirea fiducial marker. For example, in some instances, a surface matchingtechnique can be implemented. More particularly, the patient's jawbonestructure may be manipulated into a 3 D configuration in the capturedimage(s). A suitable scanning device (i.e., a physical pointer or otherimaging device such as an ultrasound transducer or OCT (opticalcoherence tomography) scanner may be attached to the end effector of thearm member 350 such that the tip of the arm member 350 is capable ofscanning the patient's jawbone structure to “surface match” the capturedand manipulated image(s) with an actual scan of the jawbone structure.

One skilled in the art will further appreciate that the association ofthe fiducial marker with the patient's anatomy, via the controllerdevice 450, may be accomplished in different manners. For example, withrespect to the registration of the image (e.g., CT scan) to the fiducialmarker, one method could involve the jaw structure of the patient beingimaged with the fiducial marker in place, as previously discussed,wherein the patient would then be substantially immediately subjected tothe implantation procedure. Such a scheme may be beneficial, forexample, in reducing the number of visits to the practitioner by thepatient. However, in some instances, the practitioner may not have theimaging capabilities at hand, or may prefer to carefully determine thevirtual implantation plan before carrying out the implantationprocedure. In both such instances, the patient will likely be requiredto return to the practitioner at a later time. Accordingly, in suchsituations, a pre-operative imaging procedure (e.g., CT scan) may beperformed on the jaw structure of the patient, without a fiducial markerin place (i.e., a “normal” scan by which the practitioner can determinethe virtual implantation plan). This pre-operative imaging procedure canthus be performed, for example, at the practitioner's site, or at adedicated scanning/imaging center. Subsequently, immediately prior tothe implantation procedure being performed, and with the fiducialmarker(s) engaged with the jaw structure of the patient, thepractitioner may capture another image (e.g., CT scan, panoramic x-ray,or two single x-rays) of the patient's jaw structure. The controllerdevice 450 may thus also be configured to correlate the pre-operativeimage (used to determine the virtual implantation procedure) with the“day of” image so as to register the fiducial marker(s) with respect tothe original pre-operative image. Such a registration or correlationprocedure may be implemented in hardware, software, or a combinationthereof, as will be appreciated by one skilled in the art. Theimplantation procedure could then proceed as otherwise disclosed herein.

In any instance, the communication element 400 is configured to engagethe arm member 350 in a manner known to the system 100, such that theposition/movement characteristics of the end effector are also known.This communication between the communication element 400 and the armmember 350 thus allows the implantation device 150 to be registered withrespect to the fiducial marker (or other reference with respect to thepatient) attached to the patient via the splint 250, the kinematicmount, the communication element 400, and the arm member 350. In thismanner, the virtual implantation process, planned through the controllerdevice 450, may be accomplished in relation to the fiducial marker (orother reference with respect to the patient) and thus translated orotherwise communicated to the system 100 for directing the implantationdevice 150.

The implantation device 150 is disposed in or otherwise engaged with theend effector of the arm member 350 (robotic arm). The arm member 350 maybe configured, for example, to provide six degrees of freedom and canalso be configured to restrict or otherwise control the movement of theimplantation device 150. Further, the arm member 350 may have aminiature parallel structure to which the implantation device 150 issecured and allowed to have full freedom of movement when not incutting/preparation/implantation mode. Since the implantation device 150is attached to the end effector of the arm member 350, the patientinteracting portion (i.e., the cutting/drilling tip) 500 (see, e.g.,FIGS. 2 and 4) of the implantation device 150 must be in a knownposition (i.e., known to the system 100) relative to the arm member 350.In some aspects, in order to calibrate the interacting portion 500 ofthe implantation device 150 with respect to the fiducial marker, acalibration element may be engaged with the implantation device 150 viaa kinematic coupling (i.e., rigidly mounted thereto in a known,repeatable manner). One skilled in the art will thus appreciate that theinteracting portion 500 of the implantation device 150 can then becalibrated with various tip calibrating methods (i.e., invariant point,etc.). Once calibrated, the calibration element is replaced with acutting/drilling element in the implantation device 150, in a known andrepeatable manner, so that the calibration parameters (i.e., theposition of the distal-most point and axis of cutting/drilling)associated with the interacting portion 500 are maintained ascalibrated.

With the alignment with respect to the patient established and known bythe system 100, and the virtual implantation plan developed through thecontroller device 450, the implantation procedure (i.e.,cutting/drilling/insertion) can then be initiated by the practitionermoving the implantation device 150 toward the patient's mouth (havingthe splint 250 engaged therewith). In such instances, the controllerdevice 450 is configured to control the movement of the implantationdevice 150 via the arm member 350 such that the action of thepractitioner merely moves interacting portion 500 (i.e., thecutting/drilling element) to the appropriate starting position for theimplantation procedure, with respect to the patient's jawbone structure,as determined by the controller device 450 and dictated by the virtualimplantation plan. Once the cutting/drilling element is in the positiondictated by the controller device 450, the invasive portion of theprocedure can then be initiated, wherein the controller device 450 mayfurther dictate other parameters of the implantation device 150 such as,for example, the orientation of the path of the cutting/drilling elementand the cutting/drilling distance along that path from thecutting/drilling origin, also according to the virtual implantationplan. In these instances, one distinction of the system 100 disclosedherein is that the implantation device 150 is not guided by thepractitioner, but is only urged by the practitioner along a proceduralroute determined via the virtual implantation plan and implemented viathe controller device 450 and the arm member 350. That is, the system100 may be configured to restrict the practitioner to performing theimplantation procedure with respect to the patient, as determined viathe virtual implantation plan and implemented via the controller device450 and the arm member 350, whereby the controller device 450 controlsthe allowable movement of the arm member 350 (and thus the implantationdevice 150) in accordance with the virtual implantation plan createdfrom the image(s) of the patient's jawbone structure. For instance, thesystem 100 may be configured for restricted movement of the arm member350/implantation device 150, as communicated to the practitioner throughtactile feedback, where, for example, the arm member 350/implantationdevice 150 may be easier to move according to the virtual implantationplan, and more difficult to move if deviating from the virtualimplantation plan. One skilled in the art will also appreciate, however,that the physical structure of the arm member 350/implantation device150 to provide fully controlled movement according to the virtualimplantation plan (i.e., due to vibration, flexing of components, and/orexcessive force applied by the practitioner) and, as such, the system100 may be further configured to provide other manners of feedback tothe practitioner such as, for example, via a deviation warning indiciaor any other suitable audio and/or visual mechanism. Therefore, thesystem 100 includes provisions for actually implementing the virtualimplantation plan, and thus facilitates a more accurate implantationprocedure, rather than merely warning the practitioner if any proceduralparameters may be inaccurate. One skilled in the art will alsoappreciate, however, that, in some instances, the system 100 may befurther configured to autonomously accomplish the virtual implantationplan, without the manipulation of the practitioner, through automaticmanipulation of the arm member 350/implantation device 150 via thecontroller device 450.

In one exemplary surgical procedure using a dental implantation system100, as disclosed herein, the splint 250 (i.e., mouthpiece) is firstattached to the patient's teeth, and thus provides a fiducial marker.The patient's jawbone structure is then imaged (with the splint 250 inplace and engaged with the patient's teeth) using, for example, CT orany other appropriate imaging technique (e.g., MRI), and the image(s)communicated with the controller device 450. The controller device 450may be further configured to be capable of executing an implantationroutine, thus allowing the practitioner to develop an implantation planfor the patient, for example, by manipulating a virtual implant withrespect to the captured image(s). Once the virtual implantation plan iscreated, the communication element 400 is engaged with the splint 250(attached to the patient's mouth, with the patient being positioned in asuitable position to initiate the procedure). The arm member 350,implantation device 150, and interacting portion 500 thereof, are thencalibrated by the practitioner (or automatically by the controllerdevice 450), before the actual cutting/drilling element of theimplantation device 150 is used by the practitioner (or autonomously viathe controller device 450), via the implantation device 150 as guided bythe arm member 350 and the controller device 450, to accomplish theimplantation procedure as planned and dictated by the virtualimplantation plan.

According to other aspects of the present disclosure, a prostheticmember 600 (e.g., a denture, reproduction tooth, etc.) may be preparedor otherwise modified by the dental implantation system 100 tocomplementarily engage the dental implant previously implanted by theimplantation system 100, by facilitating an aligned engagementtherebetween. That is, the dental implantation system 100 may beconfigured to prepare the prosthetic member(s) 600 in a manner thatallows the prosthetic member 600 to precisely correspond to and engagethe dental implant, as planned and dictated by the virtual implantationplan, so that correct alignment therebetween is achieved when theprosthetic member 600 is permanently placed with respect to the dentalimplant within the patient's mouth. In one example, the interactingportion 500 (e.g., drill element) of the implantation device 150 may beconfigured to and controlled by the controller device 450 to removematerial from the prosthetic member 600 to form a borehole which iscomplementary to and configured to receive a corresponding portion ofthe dental implant, as shown in FIG. 5. For example, in one instance,the dental implant may extend beyond the jawbone/gum line of the patientso as to provide a post or projecting member upon which the prostheticmember 600 may be mounted, seated, or otherwise secured within thepatient's mouth. Thus, the borehole of the prosthetic member 600 may beparticularly formed by the dental implantation system 100 to facilitatealignment of the prosthetic member 600 with the dental implant.

In order to form the borehole in the appropriate location or site of theprosthetic member 600, the prosthetic member 600 may be registered withthe implantation routine (i.e., registered with respect to the fiducialmarker associated with the splint 250). In one instance, the prostheticmember 600 may be introduced within the virtual implantation plan and“virtually” registered with the system 100 in relation to the fiducialmarker associated with the splint 250. In other instances, theprosthetic member 600 may be appropriately positioned within thepatient's mouth at the time of the initial scan of the patient's jawbonestructure, as previously described, so as to be physically registeredwith the fiducial marker associated with the splint 250. In suchinstances, the prosthetic member 600 may also have one or more fiducialmarkers (e.g., metallic bearing members) attached to, incorporated in,or otherwise associated therewith, wherein the prosthetic memberfiducial marker(s) may be configured to have a particular geometry orother unique characteristic or feature that readily identifies anddefines those fiducial marker(s) in the images of the patient's jawbonestructure, as well as in comparison to the fiducial marker associatedwith the splint 250. As disclosed, the fiducial marker(s) associatedwith the prosthetic member 600 may be comprised of, for example, aradiopaque material that can be clearly defined in the image (e.g., CTor MRI). By implementing the prosthetic member fiducial marker(s), theconfiguration of the prosthetic member 600 with respect those fiducialmarker(s) can be determined, and thus the system 100 can be configuredand guided according to the prosthetic member fiducial marker(s) (i.e.,according to a coordinate system associated with the prosthetic member600 and registered with the system 100) so as to allow the implantationdevice 150 to prepare the borehole at the appropriate site in theprosthetic member 600.

As a result of the imaging (and/or virtual implantation plan), theprosthetic member fiducial marker(s) may be identified in the imagingscans and then related to/registered with the system 100 so as to allowthe borehole to be appropriately formed in the prosthetic member 600.That is, once the prosthetic member 600 is registered with or known tothe controller device 450, the interacting portion 500 (or a calibrationmember), whether coupled to the implantation arm 150/arm member 350 ornot, may be brought into engagement with the fiducial member(s)associated with the physical prosthetic member 600, with the prostheticmember 600 fastened or otherwise held in a static position, to associatethe physical prosthetic device 600 with the system such that theborehole can be formed therein according to the virtual implantationplan. In any instance, the capability of preparing the prosthetic member600 via the system 100 provides an expedited dental implantation processby facilitating a more accurate alignment between the dental implant andprosthetic member 600.

Many modifications and other embodiments of the inventions set forthherein will come to mind to one skilled in the art to which theseinventions pertain having the benefit of the teachings presented in theforegoing descriptions and the associated drawings. For example, oneskilled in the art will appreciate that the systems, devices, andmethods disclosed herein may also be applicable to other surgicalprocedures such as, for instance, in neurosurgery operations involvingthe formation of a bore in the cranium. Therefore, it is to beunderstood that the inventions are not to be limited to the specificembodiments disclosed and that modifications and other embodiments areintended to be included within the scope of the appended claims.Although specific terms are employed herein, they are used in a genericand descriptive sense only and not for purposes of limitation.

That which is claimed:
 1. A dental implantation system, comprising: animplantation device adapted to prepare a site within a mouth of apatient for receiving a dental implant; and a guidance device physicallyengaged with the implantation device, the guidance device being adaptedto securely and physically interact with the mouth of the patient, thesecure and physical interaction between the guidance device and themouth of the patient forming a fiducial marker, the implantation devicethereby being configured to be in physical communication with thefiducial marker, and the guidance device being further configured tophysically regulate movement of the implantation device with respect tothe fiducial marker, in accordance with a virtual implantation plan andin correspondence with physical manipulation of the implantation deviceby a user, to prepare the site for receiving the dental implant, atleast one of the guidance device and the implantation device beingconfigured to provide tactile feedback to the user if the physicalmanipulation of the implantation device by the user deviates from thevirtual implantation plan.
 2. A system according to claim 1 furthercomprising a splint device adapted to securely and physically interactwith the mouth of the patient to form the fiducial marker, the splintdevice being in physical communication with the guidance device andcooperable therewith to physically relate the guidance device to thefiducial marker.
 3. A system according to claim 1 further comprising anarm member physically engaged with the implantation device and theguidance device, the arm member being responsive to the guidance deviceto guide the physical manipulation of the implantation device by theuser according to the virtual implantation plan to prepare the site forreceiving the dental implant.
 4. A system according to claim 1 furthercomprising a dental implant planning system configured to facilitategraphical manipulation of a jawbone structural image of the patient forforming the virtual implantation plan of the site within the mouth ofthe patient for receiving the dental implant.
 5. A system according toclaim 4 wherein the dental implant planning system is further configuredto be in communication with at least the guidance device for translatingthe virtual implantation plan to the implantation device.
 6. A method ofimplanting a dental implant, comprising: forming a fiducial markerthrough a secure and physical interaction between a guidance device anda site within a mouth of a patient; and physically regulating movementof an implantation device with the guidance device and with respect tothe fiducial marker, the implantation device being physically engagedwith the guidance device and thereby being in physical communicationwith the fiducial marker, the movement of the implantation device beingphysically regulated, in accordance with a virtual implantation plan andin correspondence with physical manipulation of the implantation deviceby a user, to prepare the site for receiving the dental implant; andproviding tactile feedback to the user, via at least one of the guidancedevice and the implantation device, if the physical manipulation of theimplantation device by the user deviates from the virtual implantationplan.
 7. A method according to claim 6 further comprising engaging themouth of the patient with a splint device in physical communication withthe guidance device, the splint device being adapted to securely andphysically interact with the mouth of the patient to form the fiducialmarker, and being cooperable therewith to physically relate the guidancedevice to the fiducial marker.
 8. A method according to claim 6 whereinphysically regulating movement of the implantation device furthercomprises physically regulating movement of the implantation device withan arm member physically engaged with the implantation device and theguidance device, the arm member being responsive to the guidance deviceto guide the physical manipulation of the implantation device by theuser according to the virtual implantation plan.
 9. A method accordingto claim 6 further comprising forming the virtual implantation plan ofthe site within the mouth of the patient for receiving the dentalimplant with a dental implant planning system configured to facilitategraphical manipulation of a jawbone structural image of the patient. 10.A method according to claim 9 wherein the dental implant planning systemis further configured to be in communication with at least the guidancedevice, and the method further comprises translating the virtualimplantation plan from the dental implant planning system to theimplantation device.
 11. A method according to claim 6 furthercomprising implanting the dental implant at the site prepared by theimplantation device.
 12. A method according to claim 11 furthercomprising relating a prosthetic member with one of the fiducial markerand the guidance device, and guiding the physical manipulation of theimplantation device by the user with the guidance device according tothe virtual implantation plan to prepare the prosthetic member foraligned engagement with the dental implant implanted at the site.
 13. Amethod according to claim 12 wherein relating a prosthetic member withthe guidance device further comprises: engaging at least one prostheticmember fiducial marker with the prosthetic member; and registering theat least one prosthetic member fiducial marker with the guidance device.14. A method according to claim 12 wherein relating a prosthetic memberwith one of the fiducial marker and the guidance device furthercomprises incorporating the prosthetic member into the virtualimplantation plan of the site within the mouth of the patient, withrespect to the dental implant, with the dental implant planning system,and translating the virtual implantation plan including the prostheticmember from the dental implant planning system to the implantationdevice.
 15. A method according to claim 12 wherein the dental implantcomprises a projecting member and preparing the prosthetic devicefurther comprises forming a channel in the prosthetic device with theimplantation device, the physical manipulation thereof by the user beingguided by the guidance device, the channel being complementarilyconfigured with respect to the projecting member according to thevirtual implantation plan, so as to provide an aligned engagementtherebetween upon the projecting member being received by the channel.